Ggent, Belgium—Patients aged 80 years and older often are prescribed numerous drugs, but a new study suggests that the medications usually are taken inappropriately.

The Belgian study, published in the British Journal of Clinical Pharmacology, also found an association between underuse of essential medications, which occurred in more than 65% of the patients, and an increased risk of dying or need for hospitalization.

The Ghent University–led researchers point out that older patients generally are more sensitive to the effects of medications than younger patients and also take a variety of prescribed drugs for multiple conditions, raising the risk of adverse interactions.

To examine patterns of prescription drug use in elderly adults, the study team focused on 503 community-dwelling adults aged 80 years and older for 18 months.

Results indicate that more than half (58%) were taking five or more chronic medications daily. Underuse occurred in 67% of patients and misuse occurred in 56%, including overlap between the two. In fact, only 17% of the patients were taking the drugs exactly as prescribed.

Underuse was associated with a 39% increase in mortality and 26% increase in hospitalization over the study period, although the link between misuse and those outcomes were less clear.

“Taking too many medications or unsafe medications are known to cause adverse health outcomes; however, we have shown that not taking essential, beneficial medications is more frequent and can be more strongly associated with negative outcomes,” said lead author Maarten Wauters. “Prescribing medications to older persons should be done after careful thought, balancing the benefits and risk of every medication at regular intervals.”

“Clinical pharmacologists can help prescribers to clearly assess misuse and underuse of medications in full knowledge of the patient, their comorbidities, and their medications,” Wauters added. “They can help to build electronic systems for constant monitoring of the quality of prescribing, using evidence-based criteria of potentially inappropriate prescribing."

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